Objectives To describe the epidemiological and clinical characteristics and outcome of hospitalized children with COVID-19 during the initial phase of the pandemic. Methods This was a cross-sectional descriptive study conducted at the dedicated COVID-19 hospital of a tertiary care referral center in North India. Consecutive children aged 14 y or younger who tested positive for SARS-CoV-2 by RT-PCR from nasopharyngeal swab between 1 April 2020 and 15 July 2020 were included. Results Of 31 children with median (IQR) age of 33 (9-96) mo, 9 (29%) were infants. About 74% (n = 23) had history of household contact. Comorbidities were noted in 6 (19%) children. More than half (58%) were asymptomatic. Of 13 symptomatic children, median (IQR) duration of symptoms was 2 (1-5.5) d. Fever (32%) was most common followed by cough (19%), rapid breathing (13%), diarrhea (10%) and vomiting (10%). Severe [n = 4, 13%] and critical [n = 1, 3%] illnesses were noted more commonly in infants with comorbidities. Three (10%) children required PICU admission and invasive ventilation; one died. Median (IQR) length of hospital stay was 15 (11-20) d. Follow up RT-PCR before discharge was performed in 17 children and the median (IQR) duration to RT-PCR negativity was 16 (12-19) d. Conclusions In the early pandemic, most children with COVID-19 had a household contact and presented with asymptomatic or mild illness. Severe and critical illness were observed in young infants and those with comorbidities.

Doctor-shopping involves visiting multiple doctors with the same health problem and is often observed in outpatient clinics.[1] Patients visit more doctors when they have a chronic disease or a drug addiction and their health problem remains unresolved despite receiving treatment.[2] The provider-patient relationship is essential to treatment of patient. If patient is visiting multiple doctors at same time without any previous records and even not disclosing previous checkups leads to repeated prescription of medication, increased drug dose consumption and increased healthcare cost as well. Here we report a case of 54 year female with chronic functional abdominal pain with once to twice weekly checkups at different hospital and with different specialist consultations. Keywords: doctor shopping, healthcare cost, drug abuse

The term vulvar leukoplakia is not a histological but a descriptive diagnosis meaning “white spot”.[1] It is used for non-inflammatory diseases characterized by pathological modification of external genitalia multilayered flat epithelium that is accompanied by skin and mucosa cornification [1]. white lesions of the vulva, primarily occur due to secondary degeneration in the epidermis caused by microvascular lesions in the dermis [2], or as a result of growth disorders and epidermal cell degeneration caused by insufficient nutrient supply after nerves and blood vessels degenerate locally. [3] here we report a case of 60 year old postmenopausal woman presenting with pruritis vulva which was later diagnosed with squamous cell hyperplasia of vulva. Keywords: postmenopausal, pruritis vulva, leukoplakia, clobetasol

The mortality is more common in the countries where the abortion is not legalized. Unsafe abortions cause 8–11% of global maternal deaths and occur predominantly in low-income and middle-income countries.[1] Medical Termination of Pregnancy (MTP Act) was passed in 1971 by Indian Parliament, with the goal to regulate and ensure accessibility for safe abortion. After the passage of this Act, legal position was given to abortion in India.[2] This act defined when, where and by whom it can be done. World Health Organization (WHO) and Federation of Obstetrician and Gynecologist Societies of India (FOGSI) have formulated guidelines for pre-abortion work up and examination for confirmation of pregnancy, correct gestational age and confirm the intra-uterine location of the pregnancy.[3] Despite liberal abortion care services provided in India, many women tend to self-medicate with abortion pills for MTP. This in turn results in high rate of unsupervised abortions and life-threatening complications. We are hereby presenting a case report on 28 year old P1+1 with history of OTC abortion pill intake at approximately 9 week with excessive bleeding per vaginum with endometritis with previous LSCS. Keywords: Abortion, self-prescribed abortion pill, OTC abortion pill, MTP, Medical Termination of PregnancyAbortion, self-prescribed abortion pill, OTC abortion pill, MTP, Medical Termination of Pregnancy

Osteoma is a benign, slow growing bone forming tumor that consists primarily of well-differentiated mature, compact or cancellous bone.[1] They usually arise on the surfaces of the cranial vault and are approximately 1-2 cm in size.[1] They are most commonly diagnosed in the fourth or fifth decades of life.[2] Only patients with symptomatic osteomas should be treated, generally by simple excision.[1] The differential diagnosis of bumps on forehead include osteoma, lipoma, sebaceous cyst, osteoblastoma, osteosarcoma and osteomyelitis. Here, we report a case of 45 year old female with bony bumps on forehead diagnosed with multiple osteomas. Keywords: Osteoma, Multiple osteoid osteomas, external table skull